Organization
TULSA MEDICAL LABORATORY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICK D GILLIS (BUSINESS MANAGER)
(918) 712-5571
Entity
Organization
Contact information
Practice address
6565 S YALE AVE, SUITE 410, TULSA, OK 74136-8327
(918) 481-7859
(918) 747-7831
Mailing address
2738 E 51ST ST, SUITE 290, TULSA, OK 74105-6231
(918) 712-5571
(918) 747-7831
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
01/15/2010
Last updated
01/28/2010
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